OncoPRN Commentary: Those working in any way in supportive oncology encounter a myriad of question with respect to complementary and alternative therapies (CAT). This article may better equip one to deal with the question of acupuncture and its use in cancer pain.

Choi TY et al. – The comparison between acupuncture plus drug therapy and drug therapy alone demonstrated a significant difference in favour of the combination therapy. The results of this systematic review provide no strong evidence for the effectiveness of acupuncture in the management of cancer pain. The total number of randomised clinical trials (RCTs) included in the analysis and their methodological quality were too low to draw firm conclusions.

Methods:

"Fourteen databases were searched from their inception through April 2011.

Randomised clinical trials (RCTs) were included if acupuncture was used as the sole treatment or as a part of a combination therapy for cancer pain.

Studies were included if they were controlled with a placebo or controlled against a drug-therapy or no-treatment group.

The Cochrane criteria were used to assess the risk of bias.

Results:

A total of 15 RCTs met the inclusion criteria.

All of the included RCTs were associated with a high risk of bias.

The majority of acupuncture treatments or combination therapies with analgesics exhibited favourable effects compared with conventional treatments in individual studies.

However, a meta-analysis suggested that acupuncture did not generate a better effect than drug therapy (n=886; risk ratio (RR), 1.12; 95% CI 0.98 to 1.28; P=0.09).

Contents of the blog:The CAPhO Compass intends to help navigate CAPhO members through resources on the world wide web, oncology pharmacy news and happenings, and much more.Here are some of the exciting new things to look forward to:

CAPhO Research Project Updates (For instance, Sean Hopkins will be providing updates on his progress)

Top 10 News/Articles/Highlights of the past 10 days

Highlighting awards open to members

Drug shortage updates

Member spotlights

Pearls of Wisdom

What’s happening and initiatives that are happening provincially/regionally

The premise is great; OxyNeo is a fairly innovative oral tablet (Concerta [methylphenidate controlled release] also utilizes this formulation) to possibly help curb abuse of one of the most highly abused prescription medications - OxyContin.

OxyNeo is not clear of problems, however, and is actually NOT desirable in a variety of patient populations.

OxyNeo tablets are formulated to make them harder to break or crush, making it difficult for people to chew OxyNeo to release all of the drug at once or crush it into a powder to snort. If one attempts to dissolve the tablets in water or alcohol, the result is a gummy gel that cannot be drawn up in a syringe.

OxyNeo and OxyContin are bioequivalent but there are slight differences:

OxyNeo takes slightly longer to reach peak levels, which may be perceived as being less effective.

have a slightly higher peak, which may ptentially lead to more side effects.

Of course, OxyNeo will not curb all abuse. Patients can still take larger amounts orally. As well, creative people are already trying to figure out how to get oxycodone more readily out of the new tablets. Crushing the tablets followed by dissolution can release over 75% of the dose, depending on the solvent utilized. There is no proof that OxyNeo is less subject to abuse or diversion.

Patients have to be cautioned NOT to wet or lick OxyNeo tablets prior to putting them in their mouth. There are reports of patients choking because the tablet forms a gummy gel when it is wet. Patients are to be told to swallow each tablet one at a time if they have to take multiple tablets per dose.

This poses a major risk to cancer patients, especially those in head and neck tumour groupings who have fiddiculties swallowing as it is.One is left to ponder if this is simply a case of altering the controlled release formulation to allow a pharmaceutical company to extend the patent (although I admittely am not certain of what that date would be and company did not disclose when asked).Reference:Pharmacist Letter Read more...

The first drug used in treating cancer is an accidental discovery. During the World War II, mustard gas was used as a warfare agent. It was discovered that individuals who were accidentally exposed to mustard gas had low WBC counts.

It was reasoned that an agent with such an effect on the rapidly-dividing WBC could have the same effect on cancer cells too.

As a result, the drug was intravenously used to treat individuals with late-stage lymphomas with dramatic early results.

Journal of Clinical Oncology Current Issue

The Lancet Oncology

European Journal of Cancer - Articles in Press

Journal of Oncology Pharmacy Practice current issue

About Onco-PRN

Welcome and thanks for visiting Onco-P.R.N. - The oncology website with a focus on all things oncology pharmacy/pain/palliative care-related. It is intended to be an information resource for those pharmacist and relevant health care professionals involved in whatever fashion with cancer and palliative care. Stay tuned for the latest and greatest links and information with respect to: oncology medications, continuing education, pharmaceutical care initiatives, pain and symptom control, supportive care topics, and whatever else that might fit into the theme.

*Note: This website is not affiliated with Alberta Health Services (AHS) or CAPhO and the opinions expressed herewithin are that of the author(s).

Pharmacy History

"The earliest known compilation of medicinal substances was ARIANA the Sushruta Samhita, an Indian Ayurvedic treatise attributed to Sushruta in the 6th century BC. However, the earliest text as preserved dates to the 3rd or 4th century AD.Many Sumerian (late 6th millennium BC - early 2nd millennium BC) cuneiform clay tablets record prescriptions for medicine.[3]

Ancient Egyptian pharmacological knowledge was recorded in various papyri such as the Ebers Papyrus of 1550 BC, and the Edwin Smith Papyrus of the 16th century BC.

The earliest known Chinese manual on materia medica is the Shennong Bencao Jing (The Divine Farmer's Herb-Root Classic), dating back to the 1st century AD. It was compiled during the Han dynasty and was attributed to the mythical Shennong. Earlier literature included lists of prescriptions for specific ailments, exemplified by a manuscript "Recipes for 52 Ailments", found in the Mawangdui tomb, sealed in 168 BC. Further details on Chinese pharmacy can be found in the Pharmacy in China article."

Journal of Palliative Medicine - Table of Contents

Traditional Romanian Pharmacy

The Sibiu Pharmacy Museum in Sibiu, Transylvania, Romania, is housed in a 1569 Gothic townhouse where the oldest pharmacy in Romania operated for over 150 years. The pharmacy was known as La Ursul Negru (The Black Bear).

Sir William Osler: "It is much more important to know what sort of a person has a disease than what sort of disease a patient has."

William Osler is regarded as McGill’s most eminent medical graduate and, as Professor of the Institutes of Medicine, the most eminent member of the McGill Medical Faculty. At the time of his death (1919), he was without question the best known and best loved physician in the English-speaking world.